Environmental Contexts Shaping Disability and Health

The relationship between the environment and health is well appreciated by the field of public health. Less understood is that the impact of the environment on health is often more significant for people with disabilities compared to those without. The reason for this stronger relationship is the numerous environmental barriers experienced by people with disabilities across multiple aspects of community living, including health care, housing, fitness and recreation, and transportation. Barriers restrict access and mobility in communities and limit participation in health-promoting activities. In contrast, environmental facilitators enable greater access and participation, providing a better person-environment fit for individuals with disabilities. Public health practitioners can play a key role in promoting environmental facilitators in their community by adopting universal design principles. Incorporating universal design principles can increase the reach of public health efforts to impact all residents, including those with a disability. In this chapter, we provide a background on the barriers experienced by people with disabilities in various types of environments and explain how this mismatch affects health. We introduce universal design principles and explain how they can be used across the three public health core functions of assessments, policy development, and assurance. Real-world case studies for each core function provide greater depth.